 <?php echo $this->load->view('_elements/navigate'); ?>

<div id="content">

    <div id="rgLeftContent">
		<div id="piTitle" class="titleI"><?php echo $Title?></div>
		<?php echo $this->load->view('_elements/byJoining'); ?>
		<div id="rgLeftBottom" class="blockstyle"></div>
	</div>
    <div id="piCenterContent">
        <div id="piTitle" class="titleI"><?php echo $Title1 ?></div>
        <div id="piForm" class="blockstyle">
             <?php echo form_open($this->curl . '/register', 'id="payment_info" name="payment_info" autocomplete="off"')?>
             <?php 
                foreach ($hiddenInfo as $key => $value)
                {
                     echo '<input type="hidden" name="'.$key.'" value="'.$value.'">';
                }
                    echo '<input type="hidden" name="friendCode" value="'.$friendCode.'">';
             ?>
             <?php echo $this->validation->error_string?>
                 <div id="piFirstName" class="formElement">
                     <div class="blue formText"><?php echo $this->user_model->fields['first_name']; ?></div>
                     <?php echo form_input('first_name', $this->validation->first_name, 'class="formInput"')?>
                 </div>
                 <div id="piLastName" class="formElement">
                     <div class="blue formText"><?php echo $this->user_model->fields['last_name']; ?></div>
                     <?php echo form_input('last_name', $this->validation->last_name, 'class="formInput"')?>
                 </div>
                 <div id="piPhoneNumber" class="formElement">
                     <div class="blue formText"><?php echo $this->user_model->fields['phone']; ?></div>
                     <?php echo form_input('phone', $this->validation->phone, 'class="formInput" style="width: 170px;"')?>&emsp;
                     <span class="lightred justify">1-555-123-4567</span>
                 </div>
                 <div id="piAddress" class="formElement">
                     <div class="blue formText"><?php echo $this->user_model->fields['address']; ?></div>
                     <?php echo form_input('address', $this->validation->address, 'class="formInput"')?>
                 </div>
                 <div id="piCity" class="formElement">
                     <div class="blue formText"><?php echo $this->user_model->fields['city']; ?></div>
                     <?php echo form_input('city', $this->validation->city, 'class="formInput"')?>
                 </div>                 
                 <div id="piCountry" class="formElement">
                     <div class="blue formText"><?php echo $this->user_model->fields['country_ID']; ?></div>
                     <?php echo form_dropdown('country_ID', $this->geo_country_model->getSelectOptions(), '', 'id="id_geo_countries" onchange="loadStates(this.value, \'place_states\',\'\',\'/site\')" class="formSelect" style="width: 215px;"', TRUE)?>
                 </div>
                 <div id="piState" class="formElement">
                     <div id="place_states">
                     </div>
                 </div>
                 <div id="piCode" class="formElement" style="margin:15px 0 0 20px">
                     <div class="blue formText"><?php echo $this->user_model->fields['zip_code']; ?></div>
                     <?php echo form_input('zip_code', $this->validation->zip_code, 'class="formInput" style="width: 120px;"')?>
                 </div>
                 <div id="piCardType" class="formElement">
                     <div class="blue formText"><?php echo $this->user_model->fields['card_type']; ?></div>
                     <?php echo form_dropdown('card_type', $this->config->item('cardTypeitem'), array($this->validation->card_type), 'class="formSelect" style="width: 180px;"', TRUE)?>
                 </div>
                 <div id="piCardNumber" class="formElement">
                     <div class="blue formText"><?php echo $this->user_model->fields['card_number']; ?></div>
                     <?php echo form_input('card_number', $this->validation->card_number, 'class="formInput"')?>
                 </div>
                 <div id="piExpDate" class="formElement">
                     <div class="blue formText"><?php echo $this->user_model->fields['exp_date']; ?></div>
                     <?php echo form_dropdown('exp_month', $this->config->item('months'), array($this->validation->exp_month), 'id="piMonth" class="formSelect" style="width: 100px; margin: 0 20px 0 0;"', TRUE)?>
                     <?php echo form_dropdown('exp_year', $this->config->item('expYearitem'), array($this->validation->exp_year), 'id="piYear" class="formSelect" style="width: 80px;"', TRUE)?>
                 </div>
                 <div id="piSecurityCode" class="formElement">
                     <div class="blue formText"><?php echo $this->user_model->fields['security_code']; ?></div>
                     <?php echo form_input('security_code', $this->validation->security_code, 'class="formInput" style="width: 70px;"')?>
                     &emsp;
                     <span class="lightred justify"><?php echo T_('What\'s This?'); ?></span>
                 </div>
                 <input type="submit" value="<?php echo T_('JOIN NOW'); ?>" name="joinnow" id="piJoinNow" class="red buttonStyle"/>
           <?php echo form_close()?>
        </div>
     </div>
     <div style="float:left; height:540px; position: relative; margin: 0 0 0 18px; width: 108px;">
     	<?php echo $this->load->view('_elements/Followrefs'); ?>
     	<div id="emblem"></div>
     </div>
     
</div>